Avandia Reduces Risk of Diabetes

Taking Avandia
(rosiglitazone) may help people at high risk for diabetes to prevent
development of the disease, according to a new study.

People at risk for diabetes because of overweight, family
history or other reasons, are advised to exercise and adhere to a
healthy diet. However, the new study suggests that rosiglitazone
may offer additional preventative help, much as
cholesterol-lowering drugs are prescribed to people with high
cholesterol to reduce heart-attack risk.

The study by the (Diabetes REduction
Assessment with ramipril and rosiglitazone
Medication) DREAM trial group was recently presented at a
meeting in Copenhagen of the European Association for the Study of
Diabetes, published online in The Lancet, and
summarized in a New York Times article on September 17.

The DREAM trial showed that who high risk for developing
diabetes who took rosiglitazone for three years had a two-thirds
lower chance of developing diabetes.

Avandia raises cells’ sensitivity to insulin and has been
used for over five years in treating people with Type 2 diabetes.
The DREAM trial is the first time Avandia has been studied on a
large scale to prevent diabetes.

Clinical Trial

The multi-center DREAM trial included about 5,000 participants
in 21 countries.

“This is a very large effect, the kind of thing that you
don’t expect to see in a clinical trial,” said Hertzel
Gerstein, the study’s main author, a professor at McMaster
University in Hamilton, Ontario, according to The New York Times.
“Ten, even five years ago, we really didn’t know what
people could do to reduce their risk of diabetes. Now we are
developing an arsenal.”

Dr Gerstein reportedly added that he “would certainly
consider using the treatment now” in some patients, although
Avandia is not approved for such use in the US.

However, despite the encouraging reports, skepticism about the
trial exists among some independent scientists and advocacy
groups:

“We’ve looked carefully at the data and it’s
just hard to know how many people would benefit and at what
cost,” said Cathy Moulton, a care adviser for Diabetes UK, an
advocacy group in London, according to The New York Times.
“We’re worried that people may think there’s a
quick fix, when what is proved to work is lifestyle changes. For
the moment, we don’t think we can solve this epidemic with a
pill.”

Diabetes Prevention?

Certainly, prescribing drugs to prevent diabetes would be highly
lucrative for pharmaceutical manufacturers – statins
(prescribed to help lower cholesterol) are a reportedly $40-billion
industry.

And there’s good reason to think diabetes prevention
– in any form – is a good idea: in addition to an
approximately 5% incidence of diabetes worldwide, researchers
estimate that another 8% may be prediabetic – that is, they
process sugar abnormally and are at high risk for diabetes.

“For the last 20 years, we have been developing a growing
number of drugs and interventions that could prevent heart
disease,” Dr Gerstein reportedly said. “Now we have
entered the era of diabetes prevention. It is very, very
important.”

But skepticism about drug prevention for diabetes remains. An
accompanying editorial in The Lancet said that
“intensive lifestyle changes…should remain the
mainstay for the prevention of Type 2 diabetes.”

Governments and healthcare providers worldwide are dealing with
what some have termed a “diabetes epidemic”. About 7%
of people in the US (20 million people) have diabetes, according to
the Centers for Disease Control and
Prevention, and about 54 million may have prediabetes (but may
not know it).

Based on these data, the authors of the recent study estimated
that for every 1,000 prediabetic people treated with rosiglitazone,
144 cases of diabetes – and their associated secondary health
risks, such as heart attack and stroke – would be
prevented.

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